Provider Demographics
NPI:1316561301
Name:RUMBAOA, DAWN DEBRA
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:DEBRA
Last Name:RUMBAOA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5021 BLOODHOUND ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89122-7770
Mailing Address - Country:US
Mailing Address - Phone:808-387-2456
Mailing Address - Fax:
Practice Address - Street 1:1109 ACACIA RD APT 324
Practice Address - Street 2:
Practice Address - City:PEARL CITY
Practice Address - State:HI
Practice Address - Zip Code:96782-2583
Practice Address - Country:US
Practice Address - Phone:808-387-2456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-04
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)